Assisted dying and the journey of discernment

By Jill Segger

July 22, 2014

“Make your mind up”. “You're sitting on the fence”. The culture tends to rebuke us for uncertainty. We are supposed to know where we stand, particularly on important moral issues. But to admit that one is still on a journey and that the destination is as yet over the horizon can be difficult.

The question of what constitutes a 'good death' and how we deal with the issues around end-of-life suffering are complex. Not least, I think, because we are still emerging from reacting to death as our Victorian forebears did to sex. We are still close enough to the sense of something taboo to have a residual uneasiness which hobbles our discourse.

There are strongly held opinions on both sides of the argument. Some of my Ekklesia colleagues have expressed themselves eloquently and have raised important questions. (http://www.ekklesia.co.uk/node/20652 and http://www.ekklesia.co.uk/node/20661) But I remain uncertain – it is perhaps the Quaker vice to 'discern' to the detriment of decision, but I have to own that I am still in the process of listening, weighing, dealing with my own emotions and experiences and that a clear path has not yet emerged for me. I dare to think there will be many people in the same condition.

It is the intensely personal nature of this issue which makes me yet wary. None of us quite know how we will truly feel when our end is close, inescapable and perhaps filled with physical and mental anguish. That proximity to death is alien to the healthy and of what we do not know, we may perhaps not usefully speak.

I think it important that this condition of unbearable extremity must not be conflated with disability – this is not about 'putting down' people whose quality of life others have deemed to be poor. Nor is it about hastening the end of those who may be considered a 'burden'. It is surely not beyond wit or law to create protections and safeguards which will ensure compassionate and right action.

On the other hand, the option to take a slightly earlier exit from this circle of being could perhaps have a deleterious longer term effect on the development of palliative care. That would have to be born in mind and no assumption made that assisted dying could ever become a substitute for the most compassionate and sensitive care for both the dying person and those who love them. Death can never really be an entirely private matter. We die both alone and as members of a community. This tension between the intensely personal and the societal demands our best efforts to listen, to weigh and – above all – to act with humility.

Leeds Area Quaker Meeting set up an End of Life Care working party just over a year ago. This has – with a nod to the ground-breaking study of sexuality undertaken by the Friends Home Service Committee 50 years ago – been referred to as 'Assisted dying – towards a Quaker view'. The choice of words is easily mocked, but I suggest that it is an honest description of how we may best seek to arrive at a sense of rightness in such a highly charged and difficult area. Here is the penultimate paragraph of the minute which followed the worship and discernment of Leeds Friends: "Throughout our deliberations what has been apparent is our sense of great compassion for those suffering at the end of their lives and the need for palliative care. We reflected on why the state of end of life care in Britain today leads some to consider the issue of assisted dying as the preferred option."

It is a beginning. And more than that, it reminds me that we need to give ourselves time to examine and reflect on this complex issue. It is worth quoting here words from Quaker Faith and Practice, written in 1979 by Philip Rack: “Some among us have a clear sense of what is right and wrong – for themselves personally if not for everyone else. They have a reassuring certitude and steadiness which can serve as a reference point by which others may navigate. There are others who live in a state of uncertainty, constantly re-thinking their responses to changing circumstances, trying to hold onto what seems fundamental but impelled to reinterpret, often even unsure where lies the boundary between the fundamental and the interpretation…”

It is in that state of uncertainty, that I recall something my father said to me when as a teenager I was struggling with a moral difficulty – “you must be the captain of your own conscience”. There had been enough seafarers in our family for me to understand that as a call to ensure that the vessel was sufficiently seaworthy to bear and protect all who might use it to venture out into unquiet waters.

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